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HOLLY BROADWATER NP NPI 1134164205


NPI Information

NPI: 1134164205
Provider Name: HOLLY BROADWATER, NP
Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Individual

Specialization: Pain Medicine

Organization: PAIN MEDICINE ASSOCIATES, P.C.

PECOS Registration: Yes

Address:
101 MED TECH PKWY
SUITE 200
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 232-6120
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Holly Broadwater, NP is a pain medicine physical medicine rehabilitation in Johnson City, TN with 22 years of experience. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. Holly Broadwater, NP NPI is 1134164205. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

101 MED TECH PKWY
SUITE 200
JOHNSON CITY, TN
ZIP 37604-007
Phone: (423) 232-6120

The NPI 1134164205 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter (HCPCS:G0434)

The enumeration date for this NPI number is 6/20/2006 and was last updated on 3/2/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12081P2900XPhysical Medicine & RehabilitationPain Medicine0370804-22TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1P00102426OTHERTENNESSEEMEDICARE RAILROAD
23907444MEDICARE ID-TYPE UNSPECIFIEDTENNESSEE
34078380OTHERTENNESSEEBLUE CROSS/BLUE SHIELD
4TN0123OTHERTENNESSEEJOHN DEERE (KPT)
5TN0122OTHERTENNESSEEJOHN DEERE (JC)
6P74568MEDICARE UPINTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.